Fraction knowledge is foundational for later mathematics achievement, yet its developmental organization remains debated and is constrained by the limited availability of grade-appropriate measures with established psychometric properties. We developed and evaluated the Fraction Knowledge Assessment (FKA), a set of grade-specific instruments for 2nd, 3rd, 5th, and 6th grades, and examined changes in fraction knowledge across two adjacent-grade transitions. Using an accelerated longitudinal design, we followed 342 children in two cohorts (2nd-3rd grade; 5th-6th grade). Participants completed standardized mathematics and cognitive measures at baseline and grade-appropriate FKAs across two consecutive years. Confirmatory factor analysis and Item Response Theory were used to examine dimensional structure, item functioning, and to link FKA versions across grades prior to developmental analyses. Results provided no strong evidence for a robust separation between conceptual and procedural fraction knowledge, with two-factor solutions showing comparable fit to one-factor models and highly correlated factors. Item-level analyses revealed developmental shifts: fraction magnitude items differentiated ability more strongly in earlier grades, whereas fraction arithmetic items were more discriminative in later grades. Using equated ability scores, significant gains were observed in both cohorts, with larger improvements from 2nd to 3rd grade than from 5th to 6th grade. Baseline mathematics achievement and working memory were longitudinally associated with later fraction knowledge. These findings support an integrated account of fraction knowledge development and illustrate how psychometrically linked, grade-appropriate assessments can be used to characterize developmental change.

Unidimensional item response theory (IRT) models are widely used even in settings where assessment data exhibit subtle forms of multidimensionality. Recent empirical evidence suggests that when item difficulty is associated with dimensionality, asymmetric item characteristic curves (ICCs) emerge in the unidimensional approximation. Through theoretical derivation and extensive simulation, this paper develops a framework for understanding the emergence and the degree of ICC asymmetry in UIRT models when applied to multidimensional data with difficulty-dimensionality associations. An empirical analysis of the Virginia Language & Literacy Screener (VALLSS) confirms the predicted patterns. These results highlight ICC asymmetry as an anticipated consequence of unidimensional approximation and underscore its relevance for applications such as vertical scaling and test linking.

This paper develops an explanatory Item Response Theory (IRT) methodology that supports the study of rating-scale design features on item sensitivity to response style. Using item response data from a previous two-part experimental study that systematically manipulated various rating scale features (e.g., the number of rating scale categories, rating scale labeling, and polarity of rating scales), a multidimensional nominal response model (MNRM) methodology is applied in which response style is represented by a latent trait that distinguishes respondents having preferences toward extreme versus middle response categories. Item discrimination parameters on the response style dimension are treated as outcomes within an explanatory IRT framework where the manipulated design features serve as predictors. Results from our analyses suggest that the number of rating scale categories was generally associated with stronger response-style discrimination, while wave, labeling and polarity conditions appeared less influential. Importantly, residual variability in response style discrimination at both the within- and between-item levels was seen in both studies to be quite high, making even statistically significant design features appear relatively weak in their effects. In both studies, the measured construct is seen to play a significant role in explaining some of that between-item heterogeneity. The results point to the feasibility of using the MNRM within an explanatory IRT framework as a basis for exploring item-level sensitivities to response style. The framework also uniquely allows for evaluating design effects against residual within-item and between-item sources of heterogeneity in response style item discrimination. The presence of substantial within- and between-item residual heterogeneity in the explanatory IRT analysis helps explain the frequent inconsistencies seen across regarding the effects of design characteristics.

Response anchoring, the tendency for respondents to provide item responses equivalent (or in close proximity) to immediately preceding responses, can reflect disengaged responding and/or cognitive challenges in comprehending test items. Using Grade 4-12 student responses to a survey measure of four social-emotional learning constructs collected from the CORE Districts in the state of California, we examine student variables that predict anchoring, and consider potential score bias and survey design implications. Response anchoring is studied using both an index of sequential response separation as well as through an IRT-based anchoring index recently considered in the literature. Both approaches show anchoring behavior increases at higher grade levels; the IRT index, however, uniquely shows anchoring to be reduced for students higher on the SEL constructs, as might be theoretically anticipated, suggesting its greater validity. Both methodological and practical implications of the analyses are considered in discussion.

BACKGROUND:Black and Hispanic adults with diabetes are more likely to experience diabetes complications and die from diabetes compared to non-Hispanic whites. This disparity may be due to medication adherence being negatively affected by social determinants of health (SDOH) and negative beliefs about diabetes and diabetes medicines. Pharmacist delivered medication therapy management (MTM) improves clinical outcomes. However, pharmacists have limited capacity and expertise to address SDOH barriers and health misperceptions. Supplementing MTM with Community Health Workers (CHWs) to address these factors may be more effective with potential for implementation. AIM:To investigate what combination of two possible components, pharmacist delivered MTM and CHWs addressing SDOH barriers and health misperceptions, represents the optimized intervention for Black and Hispanic adults with uncontrolled diabetes. METHODS/DESIGN:We will use a 2 × 2 factorial design (MTM, CHW: ON vs. OFF) where participants will be randomized to one of four treatment conditions in a 6-month intervention delivered mostly by phone. We will recruit 376 Black or Hispanic adults with type 2 diabetes and hemoglobin A1C of ≥8 %, a clinical indicator of uncontrolled type 2 diabetes. The primary outcome is A1C measured at 6 months, and at 12 months for sustained change. The secondary outcome is medication adherence. Several psychosocial factors will be examined as potential mediators. An embedded experimental mixed methods approach will be used to obtain participant perspectives through qualitative interviews and integrated to assess intervention acceptability. DISCUSSION:Our findings will identify the optimized intervention, e.g., comprising MTM or CHW or both intervention components, that effectively and efficiently improves diabetes outcomes among Black and Hispanic adults with uncontrolled diabetes, informing dissemination.

INTRODUCTION:Gait abnormalities are associated with Alzheimer's disease (AD) in the general population, but it is unclear if the same is true for individuals with Down syndrome (DS). This study examined gait across 32 months in relation to neuroimaging biomarkers (amyloid beta [Aβ], neurofibrillary tangles [NFTs], and hippocampal volume), cognitive decline, and clinical AD status in adults with DS. METHODS:Participants were 218 adults with DS who underwent Aβ and NFT positron emission tomography (PET) and magnetic resonance imaging (MRI) scans, cognitive testing, and gait assessments at baseline and 32 months. Residual change regression models were conducted. RESULTS:Higher baseline Aβ PET and NFT PET and lower MRI hippocampal volume were associated with gait declines across 32 months. Cognitive declines were associated with gait declines. Participants with clinical dementia at 32 months had greater gait decline than those who were cognitively stable. DISCUSSION:Gait impairments are a key feature of DS-associated AD (DSAD). Gait assessments could offer a quick, cost-effective, non-invasive screen for DSAD. HIGHLIGHTS:Those with clinical status of dementia had lower gait performance than those who were cognitively stable. Higher baseline amyloid beta and neurofibrillary tangle volume was associated with more gait impairments. Lower baseline hippocampal volume was associated with more gait impairments. Greater decline in gait performance was associated with cognitive decline. Greater decline in gait performance was associated with more dementia symptoms.

Understanding why interventions work is essential to optimizing them. Although mechanistic theories of meditation-based interventions (MBIs) exist, empirical evidence is limited. We randomly assigned 662 adults (79.9% reported clinical levels of anxiety or depressive symptoms) to a 4-week smartphone-based MBI or wait-list control condition early in the COVID-19 pandemic. Psychological distress and four theory-driven preregistered psychological mediators of well-being (mindful action, loneliness, cognitive defusion, and purpose) were assessed five times during the intervention period and at 3-month follow-up. In preregistered analyses, assignment to the intervention predicted significant gains on all mediators, which, in turn, significantly mediated follow-up distress (21.9%-62.5% of intervention effect on distress). No significant mediation pathway was observed in an exploratory multiple mediator analysis, but reduced loneliness accounted for 61.7% of the combined indirect effect. Multiple psychological pathways may mediate reduced distress in a digital MBI.

ObjectivesThis study explores the structure of beliefs about type 2 diabetes among Black adults and informs potential targets to reframe negative beliefs and enhance diabetes self-management.Research Design and MethodsWe applied network analysis to investigate the interrelated structure and clusters of beliefs about diabetes and identify specific items that could serve as behavioural targets. We obtained self-reported survey data from 170 Black adults with type 2 diabetes. Regularised partial correlation networks and a Gaussian graphical model were used to explore and visualise the interrelationship among 21 items of a culturally adapted Illness Perception Questionnaire-Revised.ResultsOverwhelming negative emotions representing the current and long-term effects of diabetes were central to the illness perceptions network among Black adults, with feeling depressed having the highest node strength of centrality indices in the network. Four beliefs had a bridging effect with the central cluster: diabetes taking away the ability to enjoy food, diabetes keeping me away from the job I want, being poor contributed to my having diabetes, and I receive encouragement from friends and family.ConclusionsIn addition to highlighting the overwhelming feeling of diabetes, the illness perception network further differentiated the role of racial identity and social determinants of health as discrete, though both are related sociocultural influence constructs. To enhance self-management for Black adults with type 2 diabetes, this network informs promising intervention targets focused on culturally tailored education related to emotional regulation, internalised stigma and healthy food adaptation, and leveraging support to address social determinants of health.

INTRODUCTION:Prior research suggests that the e-Cigarette Wisconsin Inventory of Smoking Dependence Motives (e-WISDM) distinguishes primary (e-PDM) and secondary dependence (e-SDM); however, there is little research on these e-WISDM dimensions and prior research comprised dual users (using cigarettes and e-cigarettes) and those using older generations of e-cigarettes. AIMS AND METHODS:Exclusive users of contemporary e-cigarettes (N = 164) completed the e-WISDM and a laboratory self-administration session and rated pre-use expectancies and post-use experiences. RESULTS:Only a 1-factor model limited to the primary scales (Automaticity, Tolerance, Craving, Loss of Control) achieved a good model fit. The e-PDM was correlated with the Penn State Electronic Cigarette Dependence Index (PS-ECDI), r = .79, p < .001. The e-PDM and PS-ECDI were similarly correlated with the use topography and self-reported measures. Analyses of motive profiles identified Taste, Tolerance, and Automaticity as the most strongly endorsed motives in the full sample. Subgroup analyses indicated primary motives were more elevated in daily versus non-daily e-cigarette users and participants with versus without a history of smoking cigarettes. Taste motives were stronger in users of third versus fourth-generation e-cigarettes. CONCLUSIONS:These findings suggest that the four e-PDM subscales are a concise, reliable, and valid measure of core e-cigarette dependence motives that are related to meaningful dependence attributes. IMPLICATIONS:Electronic cigarettes (e-cigarettes) are dependence-producing. Instruments that measure e-cigarette dependence are necessary to identify users who may have difficulty quitting e-cigarettes and who are at risk for use-related harms. The four subscales of the e-WISDM PDM index self-reported heavy e-cigarette use, craving, automatic or mindless use, and perceived loss of control over use. The current research supports the validity of the e-WISDM PDM as a measure of core e-cigarette dependence in users of today's e-cigarette devices.

We provide a review and commentary on recent methodological research related to item response theory (IRT) modelling of response styles in psychological measurement. Our review describes the different categories of IRT models that have been proposed, their associated assumptions and extensions, and the varying purposes they can serve. Our review also seeks to highlight some of the fundamental challenges shared across models in the study and statistical control of response style behaviour. We conclude with some thoughts regarding future directions, including the potential uses of response style models for sensitivity analysis and informed survey design and administration.

BACKGROUND:Hypertensive disorders of pregnancy are a leading cause of maternal and neonatal morbidity and mortality and are 60 % more common among Black birthing people than non-Black birthing people. Staying Healthy After Childbirth (STAC) is an evidence-based healthcare program that increases healthcare access by providing postpartum patients with a home blood pressure monitor and a healthcare team that remotely monitors and treats hypertension. This study adapts STAC to expand program reach for Black birthing people via implementation in community-based organizations. METHOD:The study team is partnering with community-based organizations led by and/or serving Black birthing people and Black individuals with lived experiences of hypertension during pregnancy to inform care model adaptation. Guided by the Replicating Effective Programs Framework, the study will be conducted over three stages. The pre-implementation stage will consist of identifying adaptations to STAC to align with community values and priorities. We will apply these adaptations in rapid Plan-Do-Study-Act implementation cycles to create a finalized adapted STAC (A-STAC) program. The implementation stage will consist of delivering A-STAC through community-based organizations and evaluating A-STAC effectiveness, reach, and adoption. The maintenance and evolution stage will consist of identifying strategies for sustainment of A-STAC. CONCLUSION:This adapted intervention has the potential to decrease disparities in postpartum morbidity and mortality for Black birthing people and enhance generational health equity.

Introduction This research investigated the extent to which three nicotine products promote day-level cigarette substitution during a 1-week switch attempt Methods Adults who smoked daily but were not motivated to quit were randomized to 4 weeks using: 1) very low nicotine cigarettes (VLNCs), 2) e-cigarettes, or 3) no product. During two separate switch weeks, participants were instructed to abstain from their own cigarettes and switch to using their study product (if assigned one). Participants were also assigned to use active nicotine patches during one switch week and placebo patches during the other. Nightly smartphone surveys assessed use of participants’ own-brand cigarettes. Average marginal effects from a logistic regression model characterized effects of trial design variables on day-level own-cigarette abstinence. Results Participants (N = 196) recorded 4,998 evening reports. Switch weeks were associated with an average marginal increase in abstinence rate by 27.9 percentage points (p <.001). The switch week effect was significantly larger in the VLNC (35.9 percentage points), and e-cigarette (31.2) groups compared to the no product group (16.4; ps <.05). Use of active patches during the first switch week increased abstinence by 6.9 percentage points on average (p =.010), but use of active patches during the second switch week decreased abstinence probability by 9.6 percentage points (p =.032, difference p =.010) Conclusions VLNCs and e-cigarettes meaningfully and equivalently increase the probability of day-level abstinence from one’s own cigarettes. Transdermal nicotine promotes cigarette substitution, but only when provided early in the switching process.

Some evidence suggests that anhedonia is a component of nicotine withdrawal, but additional research is needed to support this conclusion and establish its clinical relevance. Secondary analyses were conducted for a comparative effectiveness smoking cessation clinical trial of combination nicotine replacement therapy, nicotine patches, and varenicline (N = 1,084). Self-reported consummatory anhedonia was assessed at multiple time points pretarget quit day (TQD) and post-TQD, and biochemically confirmed 7-day point-prevalence smoking abstinence was assessed at 4, 12, and 26 weeks post-TQD. Data collection occurred from May 2012 to November 2015. Analyses were conducted using hierarchical linear modeling, logistic regression, and general linear models. Anhedonia demonstrated a prototypical inverted-U pattern from pre- to post-TQD consistent with withdrawal, which was not moderated by medication condition (ps > .83). Greater postquit anhedonia was associated with lower odds of biochemically confirmed abstinence at 4 weeks (odds ratio [OR] = 0.96, 95% confidence interval [CI] = [0.94, 0.98], p < .001), 12 weeks (OR = 0.96, 95% CI = [0.94, 0.99], p = .001), and 26 weeks (OR = 0.95, 95% CI = [0.93, 0.98], p < .001) post-TQD. These effects remained even after controlling for other withdrawal symptoms and individual characteristics. Gold standard smoking pharmacotherapies had comparable statistical effects on anhedonia's trajectory and association with abstinence during treatment. The results replicate and extend previous research supporting anhedonia as a motivationally significant symptom of nicotine withdrawal. The results suggest anhedonia not only conforms to features of a tobacco withdrawal symptom but is associated with difficulty stopping smoking. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Background Pancreatic resection offers the only chance for cure for pancreatic ductal adenocarcinoma, but resection is associated with significant morbidity. Data are lacking about whether patients understand the risks/benefits of surgical resection. This survey study prospectively assessed patient understanding of expected oncologic outcomes after pancreatectomy. Methods A 14-question survey was distributed between 2020 and 2022 to patients planning to undergo pancreatectomy at eight geographically diverse institutions performing high-volume pancreatic surgery. The survey assessed demographics, expectations about post-resection outcomes, and perceived quality of patient-surgeon communication. Associations between demographics and survey responses were assessed with Fisher's exact test and Goodman-Kruskal's lambda. Results 152 surveys were received (response rate 39 %; n = 152/376). Almost all patients believed surgery was likely to prolong survival (146/147, 99 %); cure their cancer (126/141, 89 %); and/or ameliorate health problems due to cancer (127/136, 93 %). Regarding patient-surgeon communication, 134/150 (89 %) reported surgeons always listened carefully, and 134/150 (89 %) reported surgeons gave clear explanations. There were no meaningful associations between demographics and understanding of expected post-resection outcomes. Discussion Most patients believed surgery was likely curative and were satisfied with patient-surgeon communication. These data outline a critical opportunity for surgical oncologists to improve pre-operative counseling and ensure patients have accurate information to support complex decision-making.

Item response theory (IRT) encompasses a broader class of measurement models than is commonly appreciated by practitioners in educational measurement. For measures of vocabulary and its development, we show how psychological theory might in certain instances support unipolar IRT modeling as a superior alternative to the more traditional bipolar IRT models fit in practice. Although corresponding model choices make unipolar IRT statistically equivalent with bipolar IRT, adopting the unipolar approach substantially alters the resulting metric for proficiency. This shift can have substantial implications for educational research and practices that depend heavily on interval-level score interpretations. As an example, we illustrate through simulation how the perspective of unipolar IRT may account for inconsistencies seen across empirical studies in the observation (or lack thereof) of Matthew effects in reading/vocabulary development (i.e., growth being positively correlated with baseline proficiency), despite theoretical expectations for their presence. Additionally, a unipolar measurement perspective can reflect the anticipated diversification of vocabulary as proficiency level increases. Implications of unipolar IRT representations for constructing tests of vocabulary proficiency and evaluating measurement error are discussed.

BackgroundEcological momentary assessment (EMA) is increasingly being incorporated into intervention studies to acquire a more fine-grained and ecologically valid assessment of change. The added utility of including relatively burdensome EMA measures in a clinical trial hinges on several psychometric assumptions, including that these measure are (1) reliable, (2) related to but not redundant with conventional self-report measures (convergent and discriminant validity), (3) sensitive to intervention-related change, and (4) associated with a clinically relevant criterion of improvement (criterion validity) above conventional self-report measures (incremental validity). ObjectiveThis study aimed to evaluate the reliability, validity, and sensitivity to change of conventional self-report versus EMA measures of rumination improvement. MethodsWe conducted a secondary analysis of data from 4 trials of app-based meditation interventions (N=412). Participants included adolescents (samples 1-2; n=232, 56.3%; aged 12-15 years), college students (sample 3; n=88, 21.4%; aged 18-21 years), and adults (sample 4; n=92, 22.3%; aged 18-80 years). All participants completed validated conventional self-report rumination measures (Children’s Response Styles Questionnaire, Response Styles Questionnaire, or Perseverative Thinking Questionnaire) at baseline and the postintervention time point and EMA rumination assessments throughout 3- to 4-week intervention periods (mean compliance 72.2%-80.2%). We examined the reliability of conventional self-report and EMA measures, computed correlations between measurement approaches, compared rumination improvement using standardized effect sizes, and tested criterion validity by predicting depression symptom improvement. ResultsReliability of conventional self-report rumination was high at baseline (Cronbach α=0.89-0.94) and the postintervention time point (Cronbach α=0.90-0.95) but decreased for residualized change scores (ρ= 0.71-0.90). EMA rumination showed high mean-level reliability (ρ=0.89-0.96) but substantially lower reliability for change scores (ρ=0.50-0.77). Conventional self-report and EMA measures showed medium correlations at individual time points (r=0.28-0.47; P<.01 in all cases) but nonsignificant correlations between change scores (Child and Adolescent Research in Emotion samples: r=0.03 and P=.66; Healthy Minds Program sample: r=0.20 and P=.06). Conventional self-report detected larger intervention effects than EMA measures (Cohen d=0.37 vs 0.14 for group differences; Cohen d=0.77 vs 0.17 for pretest-posttest change). Despite modest intercorrelations, both measurement approaches demonstrated incremental predictive validity for depression improvement. In the Child and Adolescent Research in Emotion samples, improvements in both conventional rumination (b=0.04; SE 0.017; P=.03) and EMA rumination (b=0.03; SE 0.014; P=.04) significantly predicted reduced depression symptoms until the 12-week follow-up. Similarly, in the Healthy Minds Program sample, both conventional rumination change (b=0.23; SE 0.060; P<.001) and EMA rumination change (b=20.49; SE 9.94; P=.04) predicted depression improvement. ConclusionsConventional self-report and EMA measures of rumination provide distinct and clinically meaningful information. When deciding to use EMA in intervention studies, researchers should carefully consider the psychometric properties of their measures and the precise construct they intend to capture.

IntroductionWithin two-parent households, the parent-couple subsystem (marital or romantic partner relationship) is posited to shape the mental health of both parents and children. Autistic children and their parents have an elevated-risk for mental health problems. The present study longitudinally examined the mediating role of the quality of the parent-couple relationship in time-ordered pathways between changes in the mental health problems of autistic children and in parent depression symptoms at a within-family level.MethodologyUsing four time points of data collected on 188 families of autistic children (aged 5–12 years) across 3 years, the bidirectional associations between parent-couple relationship satisfaction, parent depressive symptoms, and child internalizing and externalizing mental health problems were investigated. Two multi-group (grouped by parent gender) complete longitudinal mediation models in structural equation modeling using Mplus software were conducted.ResultsParent-couple relationship satisfaction mediated: (1) the association between higher parent depressive symptoms and higher child internalizing mental health problems 12 months later for both mothers and fathers, and (2) the association between higher child externalizing mental health problems and higher father depression symptoms 12 months later. Father depression symptoms mediated a pathway from lower parent-couple satisfaction to higher child internalizing mental health problems 12 months later, and mother depression symptoms mediated the pathway from higher child externalizing mental health problems to lower parent-couple satisfaction 12 months later.ConclusionFindings highlight the bidirectional and complex ways that parent and child mental health and the quality of the parent-couple relationship are entwined across time in families of autistic children. Family-wide interventions that address the needs of multiple family members and family systems are best suited to improve the mental health of parents and autistic children.

The purpose of this study was to examine the efficacy of the Family Check-Up initiated during kindergarten on teacher-report of children's emotional and behavior concerns in fourth grade. Participants were 57 primary caregivers, along with their children and teachers. Participants were randomized to a Family Check-Up condition or school-as-usual control condition. Teachers reported on children's emotional and behavior concerns at kindergarten and fourth grade. Findings suggested children whose caregivers were randomized to the Family Check-Up condition outperformed children in the school-as-usual control condition on moderate and serious emotional and behavior concerns in fourth grade. Implications for aligning and integrating family-centered assessment and treatment in schools are discussed.

Background Large scale international assessments depend on invariance of measurement across countries. An important consideration when observing cross-national differential item functioning (DIF) is whether the DIF actually reflects a source of bias, or might instead be a methodological artifact reflecting item response theory (IRT) model misspecification. Determining the validity of the source of DIF has implications for how it is handled in practice.Method We demonstrate a form of sensitivity analysis that can point to model misspecification induced by item complexity as a possible cause of DIF, and show how such a cause of DIF might be accommodated through attempts to generalize the IRT model for the studied item(s) in psychometrically and psychologically plausible ways.Results In both simulated illustrations and empirical data from TIMSS 2011 and TIMSS 2019 4th and 8th Grade Math and Science, we have found that using a form of proposed IRT model generalization can substantially reduce DIF when IRT model misspecification is at least a partial cause of the observed DIF.Conclusions By demonstrating item complexity as a possible valid source of DIF and showing the effectiveness of the proposed approach, we recommend additional attention toward model generalizations as a means of addressing and/or understanding DIF.